The decision taken during the First International Congress on the Menopause in June 1976 to repeat the exercise 2 years later turned out to be a good one. In the last few years much work has been done on the subject of the menopause. I t is, of course, a subject of many facets, but of particular importance recently has been the work done as a result of the reports appearing in 1975 and 1976 alleging an increase in the incidence of endometrial carcinoma in women who had used oestrogens, and of other effects, some beneficial others deleterious, reportedly seen when oestrogens were administered. 1978 seemed the right time to re-assess the situation, and the Second Inter national Congress on the Menopause provided a good platform. The congress was held in Jerusalem in June 1978. It took the form of a series of 12 workshops, each of which, within a prescribed framework, was planned and presided over by a moderator experi enced in that particular field. The 12 moderators were free to organize their sessions in whichever way they wished, and to invite whoever they wished to present papers and to join in the discussions. In addition the workshops were open to anyone who wished to attend."

R. B. GREENBLATT The original oral contraceptives contained more oestrogen in the form of ethinyloestradiol or mestranol and progestagen in the form of norethynodrel or norethisterone than was necessary f(x conception control. There has been a trend over the years to reduce dosages of both components in order to minimize side- eHects while ensuring eflcctiveness. However, as dosages were lowered, there has been an increase in spotting and break- through bleeding during the first few months of their adminis- tration. The sequential pill appeared more physiological in that it followed more closely physiological principles, but the need to employ large doses ofEE or EE3ME to inhibit O\'ulation and the higher pregnancy rate made the sequential regimen less attrac- ti\'e or useful. A triphasic formulation has become available that takes advantage of the synergism between ethinyloestradiol and the potent levonorgestrel so that low doses of the oestrogen and very low doses of the progestagen could be employed with great effectiveness. Such a preparation is relatively free from side- effects, partly because the basic pharmacological tenet of the minimal dose for the desired result and the division of'the cycle into three parts using 30 ,lIg ofEE for the first 6 days, then:) days of 40 ,lIg, followed by 30 ,fIg for 10 da ys, for a total of21 days, thus more or less mimicking the physiological rise and fall of 125 THE DEVELOP:'IE:-;T OF ,\ :-;E\\' TRIPH. \SIC OR.

This book contains a consensus on menopause research, a consensus reached during the First International Congress on the Menopause in June, 1976. The Congress brought together about 165 people, most of whom are engaged in research in this field, in the resort town of La Grande Motte, near Montpellier, France. It was planned so that the main emphasis would be on the exchange of information in small Workshop sessions. Workshop Chairmen were asked to present summaries of their deliberations at the closing session. It is these summaries that form the essence of this text. The Congress also included six Free Communications sessions. They are represented in this book by a small number of papers printed in full (selected from some 40 contributions in all) that in the opinion of the editors, contain data that particularly complement the Workshop summaries. All other papers are mentioned in these Pro ceedings by titles and by the name, affiliation and address of the first author. Organizing this Congress was a stimulating and heart-warming experience. It was done by the staff of the International Health Foundation in Brussels and Geneva, under the considerate auspices of the American Geriatric Society and the Medical Faculty of the University of Montpellier. We are deeply grateful to these two bodies."